Chiu Li-Chung, Lin Shu-Min, Lo Yu-Lun, Kuo Scott Chih-Hsi, Yang Cheng-Ta, Hsu Ping-Chih
Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan.
Department of Thoracic Medicine, New Taipei Municipal Tu Cheng Hospital, New Taipei City 23652, Taiwan.
Vaccines (Basel). 2021 Jun 23;9(7):689. doi: 10.3390/vaccines9070689.
Early-stage NSCLC (stages I and II, and some IIIA diseases) accounts for approximately 30% of non-small cell lung cancer (NSCLC) cases, with surgery being its main treatment modality. The risk of disease recurrence and cancer-related death, however, remains high among NSCLC patients after complete surgical resection. In previous studies on the long-term follow-up of post-operative NSCLC, the results showed that the five-year survival rate was about 65% for stage IB and about 35% for stage IIIA diseases. Platinum-based chemotherapy with or without radiation therapy has been used as a neoadjuvant therapy or post-operative adjuvant therapy in NSCLC, but the improvement of survival is limited. Immune checkpoint inhibitors (ICIs) have effectively improved the 5-year survival of advanced NSCLC patients. Cancer vaccination has also been explored and used in the prevention of cancer or reducing disease recurrence in resected NSCLC. Here, we review studies that have focused on the use of immunotherapies (i.e., ICIs and vaccination) in surgically resectable NSCLC. We present the results of completed clinical trials that have used ICIs as neoadjuvant therapies in pre-operative NSCLC. Ongoing clinical trials investigating ICIs as neoadjuvant and adjuvant therapies are also summarized.
早期非小细胞肺癌(I期和II期,以及部分IIIA期疾病)约占非小细胞肺癌(NSCLC)病例的30%,手术是其主要治疗方式。然而,在完全手术切除后,NSCLC患者的疾病复发风险和癌症相关死亡风险仍然很高。在以往关于术后NSCLC长期随访的研究中,结果显示IB期的五年生存率约为65%,IIIA期疾病的五年生存率约为35%。含铂化疗联合或不联合放疗已被用作NSCLC的新辅助治疗或术后辅助治疗,但生存改善有限。免疫检查点抑制剂(ICI)有效提高了晚期NSCLC患者的5年生存率。癌症疫苗也已被探索并用于预防癌症或减少切除的NSCLC中的疾病复发。在此,我们综述了专注于在可手术切除的NSCLC中使用免疫疗法(即ICI和疫苗接种)的研究。我们展示了已完成的将ICI用作术前NSCLC新辅助治疗的临床试验结果。还总结了正在进行的将ICI用作新辅助和辅助治疗的临床试验。